Cognitive-behavioural therapy for patients with schizophrenia: a multicentre randomized controlled trial in Beijing, China

BACKGROUND

Meta-analyses support the efficacy of cognitive-behavioural therapy (CBT) for schizophrenia in western cultures. This study aimed to compare the efficacy of CBT and supportive therapy (ST) for patients with schizophrenia in China.

METHOD

A multicentre randomized controlled, single-blinded, parallel-group trial enrolled a sample of 192 patients with schizophrenia. All patients were offered 15 sessions of either CBT or ST over 24 weeks and followed up for an additional 60 weeks. All measures used were standardized instruments with good reliability and validity. The Positive and Negative Syndrome Scale (PANSS) was used to assess symptoms of schizophrenia. The Schedule for Assessing Insight (SAI) was used to assess patients' insight and the Personal and Social Performance Scale (PSP) was used to assess their social functioning.

RESULTS

Effect-size analysis showed that patients made rapid improvements in all symptoms, insight and social functioning as measured by the PANSS, SAI and PSP at 12 and 24 weeks and maintained these improvements over the course of the study to 84 weeks. Patients in the CBT group showed significantly greater and more durable improvement in PANSS total score (p = 0.045, between-group d = 0.48), positive symptoms (p = 0.018, between-group d = 0.42) and social functioning (p = 0.037, between-group d = 0.64), with significant differences emerging after completion of therapy.

CONCLUSIONS

Both CBT and ST combined with medication had benefits on psychopathology, insight and social functioning of patients with schizophrenia. CBT was significantly more effective than ST on overall, positive symptoms and social functioning of patients with schizophrenia in the long term.

Solution studies on DNA interactions of substitution-inert platinum complexes mediated via the phosphate clamp

The phosphate clamp is a distinct mode of ligand-DNA binding where the molecular recognition is manifested through ("non-covalent") hydrogen-bonding from am(m)ines of polynuclear platinum complexes to the phosphate oxygens on the oligonucleotide backbone. This third mode of DNA binding is unique to the "classical" DNA intercalators and minor groove binding agents and even the closely related covalently binding mononuclear and polynuclear drugs. 2D (1)H NMR studies on the Dickerson-Drew dodecamer (DDD, d(CGCGAATTCGCG)2) showed significant A-T contacts mainly on nucleotides A6, T7 and T8 implying a selective bridging from C9G10 in the 3' direction to C9G10 of the opposite strand. {(1)H, (15)N} HSQC NMR spectroscopy using the fully (15)N-labelled compound [{trans-Pt(NH2)3(H2N(CH2)6NH3}2μ-(H2N(CH2)6NH2)2(Pt(NH3)2](8+) (TriplatinNC) showed at pH 6 significant chemical shifts and (1)J((195)Pt-(15)N) coupling constants for the free drug and DDD-TriplatinNC at pH 7 indicative of formation of the phosphate clamp. (31)P NMR results are also reported for the hexamer d(CGTACG)2 showing changes in (31)P NMR chemical shifts indicative of changes around the phosphorus center. The studies confirm the DNA binding modes by substitution-inert (non-covalent) polynuclear platinum complexes and help in further establishing the chemotype as a new class of potential anti-tumour agents in their own right with a distinct profile of biological activity.

Association of the FABP2 Ala54Thr polymorphism with type 2 diabetes, obesity, and metabolic syndrome: a population-based case-control study and a systematic meta-analysis

Previous studies have reported associations between the functional FABP2 Ala54Thr (rs1799883) polymorphism and type 2 diabetes mellitus (T2DM), obesity, and metabolic syndrome in different populations with conflicting results. We investigated the association between the FABP2 Ala54Thr polymorphism and T2DM (235 cases, 431 controls), obesity (377 cases, 431 controls), and metabolic syndrome (315 cases, 323 controls) by logistic regression analysis in a Chinese study cohort recruited from Yichang, Hubei Province. We then comprehensively reviewed the association of the FABP2 Ala54Thr polymorphism with T2DM, obesity, and metabolic syndrome via meta-analysis. The strength of association was assessed by odds ratios (ORs) with 95% confidence intervals (CIs). The FABP2 Ala54Thr polymorphism was significantly associated with obesity (AT vs AA: OR = 2.633, 95%CI = 1.065-6.663, P = 0.036; TT vs AA: OR = 4.160, 95%CI = 1.609-10.757, P = 0.003) and metabolic syndrome (TT vs AA: OR = 2.273, 95%CI = 1.242-4.156, P = 0.008) by logistic regression with adjustment for covariates. However, no significant association was found between T2DM and the FABP2 Ala54Thr polymorphism. We identified 24 studies on T2DM (4517 cases, 5224 controls), 9 studies on obesity (949 cases, 2002 controls), and 6 studies on metabolic syndrome (2194 cases, 3282 controls) by literature search. The meta-analyses revealed significant associations for metabolic syndrome (T allele: OR = 1.179, 95%CI = 1.015-1.362, P = 0.031) and T2DM (T allele: OR = 1.160, 95%CI = 1.08-1.24, P < 0.001), but no association for obesity (T allele: OR = 1.069, 95%CI = 0.925-1.235, P = 0.367).

Knockdown of NF-κB p65 subunit expression suppresses growth of nude mouse lung tumor cell xenografts by activation of Bax apoptotic pathway

Nuclear factor-kappaB (NF-κB) is an important transcriptional factor and regulates a variety of pathophysiologic process involved in cell survival and death. The present study assesses the effects of NF-κB p65 subunit knockdown in suppression of nude mouse lung tumor cell xenografts and understands the underlying molecular events.A nude mouse Lewis lung carcinoma cell xenograft model was established and the mice were intraperitoneally injected with NF-κB p65 siRNA and sacrificed after two weeks of tumor cell injection. Tumor xenografts were harvested for TUNEL, Western blot, and qRT-PCR analyses.Compared to the PBS-treated or the negative control (NC) siRNA-treated mice, tumor xenograft weight and volume was significantly decreased in the NF-κB p65 siRNA-treated mice. The TUNEL positive (apoptosis) cells in xenograft sections were 45 ± 5 in PBS and 38 ± 3 in NC siRNA, but increased to 271 ± 11 in p65 siRNA-treated mice. Compared to the PBS or the NC mice, levels of Bax mRNA and protein in tumor xenografts were significantly upregulated in p65 siRNA-treated mice. Knockdown of NF-κB p65 subunit expression significantly inhibited the growth of nude mouse Lewis tumor cell xenografts by induction of tumor cell apoptosis and significantly up-regulation of pro-apoptotic protein Bax expression. Future study will confirm the current data and targeting NF-κB p65 subunit expression as a potential therapeutic strategy in treating human lung cancer.

KEYWORDS

NF-κB, lung cancer, apoptosis, small interfering RNA, xenografts.

Genetic variation in COX-2 -1195 and the risk of endometriosis and adenomyosis

AIM

Ths study aims to explore the relationship between COX-2 gene polymorphism and the hereditary susceptibility or endoomeyriosis and adenomyosis.

MATERIALS AND METHODS

Gene polymorphism in COX-2 gene was genotyped in 170 cases of endometriosis, 150 cases of adenomyosis, and 240 matched non-endometriosis and non-adenomyosis controls.

RESULTS

Genotypic frequencies of GG, AG, and AA in COX-2 locus in endometriosis and adenomyosis were 16.5%, 51.2%, 32.4% and 16.0%, 49.3%, 34.7%, respectively. They were both significantly different from those in the control group (24.6%, 53.3%, and 22.1%) (p < 0.05). An allele frequency in endometriosis and adenomyosis were significantly higher than that in the control group. The risk of endometriosis or adenomyosis for those carrying two A alleles were 2.19 and 2.41 times to non-A genotype.

CONCLUSION

Genetic variation of G to A at -1195 locus in the promoter region of COX-2 gene increases the risk of endometriosis and adenomyosis, and the genetic susceptibility of these two diseases are similar.

Association of polymorphisms of angiotensin I converting enzyme 2 with retinopathy in type 2 diabetes mellitus among Chinese individuals

AIMS

To examine the association of Angiotensin I converting enzyme 2 (ACE2) gene polymorphisms and retinopathy in a Chinese type 2 diabetes mellitus (T2DM) cohort.

METHODS

A total of 743 T2DM participants were involved in this study including 408 female and 335 male cases. Female cases were divided into two groups: diabetes without retinopathy (DNR group, n=171) and with retinopathy (DR group, n=237), the latter was further subclassified into nonproliferative DR (NPDR group, n=121) and proliferative DR (PDR group, n=116). Male cases were assigned to DNR group (n=153) and DR group (n=182) which was further grouped into NPDR group (n=86) and PDR group (n=96). Two single nucleotide polymorphisms (SNPs; rs2074192 and rs714205) in ACE2 gene were genotyped.

RESULTS

In female cases, the frequency of genotypes TT in rs2074192 and CC in rs714205 were higher in DR and PDR group than in DNR group (P<0.05). The frequency of alleles T in SNP rs2074192 and C in SNP rs714205 was higher in DR group (P<0.05) and PDR group (P<0.05) than in DNR group. The frequency of allele T in SNP rs2074192 was higher in PDR group (P=0.04) than in NPDR group. The frequency of haplotype TC and CG was higher in DR and PDR groups, respectively (P<0.05). No positive results were found in male cases.

CONCLUSIONS

Our results revealed that SNPs rs2074192 and rs714205 in ACE2 gene were associated with the susceptibility of DR and PDR.

[Expressions of Dab2 and ERK1 in esophageal carcinoma tissues and their clinical significance]

OBJECTIVE

To explore the expressions of protein and mRNA of disabled-2 (Dab2) and extracellular signal-regulated kinase1 (ERK1) in esophageal squamous cell carcinoma tissue (ESCC) and their clinical significance.

METHODS

The expressions of protein and mRNA of Dab2 and ERK1 were detected in ESCC (n = 59), atypical hyperplasia (n = 27) and normal esophageal mucosa (n = 36) tissues by immunohistochemistry, in situ hybridization and reverse transcription polymerase chain reaction (RT-PCR).

RESULTS

The expressions of protein and mRNA of Dab2 were lesser in ESCC than those in atypical hyperplasia and normal esophageal mucosa tissues (23.7% vs 94.4%, 44.4% and 18.6% vs 97.2%, 33.3%). And the expressions of protein and mRNA ERK1 were higher in ESCC than those in atypical hyperplasia and normal esophageal mucosa tissues (81.4% vs 44.4%, 63.0% and 78.0% vs 30.6%, 51.9%) (all P < 0.05). Additionally, the expressions of protein and mRNA of Dab2 and ERK1 were closely related with lymph node metastasis in ESCC tissue and the expressions of protein and mRNA of ERK1 closely related with the depth of tumor invasion in ESCC tissue (all P < 0.05). Furthermore, the results of correlation analysis revealed that expressions of protein and mRNA of Dab2 and ERK1 in ESCC had a negative correlation (all P < 0.05).

CONCLUSION

The expressions of protein and mRNA of Dab2 and ERK1 play important roles in the infiltration, metastasis and carcinogenesis of ESCC and their effects may be antagonistic to each other.

Dairy foods and risk of stroke: a meta-analysis of prospective cohort studies

BACKGROUND AND AIMS

Epidemiological studies evaluating the association of dairy foods with risk of stroke have produced inconsistent results. We conducted a meta-analysis to summarize the evidence from prospective cohort studies regarding the association between dairy foods and risk of stroke.

METHODS AND RESULTS

Pertinent studies were identified by searching Embase (1950-November, 2013), Web of Knowledge (1950-November, 2013) and Pubmed (1945-November, 2013). Random-effect model was used to combine the results. Dose-response relationship was assessed by restricted cubic spline. Eighteen separate results from fifteen prospective cohort studies, with 28,138 stroke events among 764,635 participants, were included. Total dairy [relative risk (95% CI): 0.88 (0.82-0.94)], low-fat dairy [0.91 (0.85-0.97)], fermented milk [0.80 (0.71-0.89)] and cheese [0.94 (0.89-0.995)] were significantly associated with reduced risk of stroke, but whole/high-fat dairy, nonfermented milk, butter and cream were not significantly associated with risk of stroke. Stronger association was found for stroke mortality than incidence, and for studies conducted in Asia than Europe, while the association did not differ significantly by sex. Limited data did not find any significant association with either ischemic or hemorrhagic stroke. A non-linear dose-response relationship (P = 2.80*10(-13)) between milk and risk of stroke was found, and the relative risk of stroke was 0.88 (0.86-0.91), 0.82 (0.79-0.86), 0.83 (0.79-0.86), 0.85 (0.81-0.89), 0.86 (0.82-0.91), 0.91 (0.84-0.98) and 0.94 (0.86-1.02) for 100, 200, 300, 400, 500, 600 and 700 ml/day of milk, respectively.

CONCLUSIONS

Dairy foods might be inversely associated with the risk of stroke.

Contrasting weight changes with LY2605541, a novel long-acting insulin, and insulin glargine despite similar improved glycaemic control in T1DM and T2DM

AIMS

The basal insulin analogue LY2605541, a PEGylated insulin lispro with prolonged duration of action, was previously shown to be associated with modest weight loss in Phase 2, randomized, open-label trials in type 2 (N=288) and type 1 (N=137) diabetes mellitus (T2DM and T1DM), compared with modest weight gain with insulin glargine. Exploratory analyses were conducted to further characterize these findings.

METHODS

Pearson correlations between change in body weight and other variables were calculated. Continuous variables were analysed using a mixed linear model with repeated measurements. Proportions of subjects with weight loss were analysed using Fisher's exact test for T2DM and Nagelkerke's method for T1DM.

RESULTS

Weight loss was more common in LY2605541-treated patients than in patients treated with insulin glargine (T2DM: 56.9 vs. 40.2%, p=0.011; T1DM: 66.1 vs. 40.3%, p<0.001). More LY2605541-treated patients experienced ≥5% weight loss compared to patients treated with glargine (T2DM: 4.8 vs. 0%, p=0.033; T1DM: 11.9 vs. 0.8%, p<0.001). In both the T1DM and T2DM studies, weight change did not correlate with baseline body mass index (BMI), or change in HDL-cholesterol in either treatment group. No consistent correlations were found across both studies between weight change and any of the variables assessed; however, weight change was significantly correlated with hypoglycaemia rate in glargine-treated T2DM patients.

CONCLUSION

In two Phase 2 trials, improved glycaemic control with long-acting basal insulin analogue LY2605541 is associated with weight loss in previously insulin-treated patients. This weight change is independent of baseline BMI or hypoglycaemia.

[Effects of S100A7 on the proliferation and invasiveness of esophageal squamous cell carcinoma EC9706 cells and possible mechanisms]

OBJECTIVE

To explore the expression of S100A7 in esophageal squamous cell carcinoma (ESCC) and examine the effect of S100A7 down-regulated expression mediated via RNA interfering on cell proliferation and invasion.

METHODS

The expressions of S100A7 mRNA and protein were analyzed by in situ hybridization and immunohistochemistry.S100A7 siRNA was transfected into ESCC cell line EC9706 and the expressions of S100A7 mRNA and protein were detected by real-time polymerase chain reaction (PCR) and Western blot.Furthermore, the effects of down-regulated of S100A7 on cell proliferation and invasion were examine by Cell Counting Kit-8 (CCK-8) and Boyden chamber respectively.Finally the effect of down-regulated expression of S100A7 on matrix metalloproteinase-2 (MMP-2) protein was analyzed by Western blot.

RESULTS

Positive expression ratios of S100A7 mRNA and protein expressions in ESCC tissues (72.0% and 69.3%) were significantly higher than those in normal esophageal tissues (10.7% and 8.0%) (χ² = 58.174 and 59.483, both P = 0.000). The expressions of S100A7 mRNA and protein in S100A7 siRNA group were markedly lower than those in untreated group (mRNA: 0.235 ± 0.056 vs 1, protein: 0.119 ± 0.025 vs 0.518 ± 0.129, both P < 0.05). Additionally, the down-regulated expression of S100A7 resulted in the proliferation inhibition and the decreased invasiveness in EC9706 cells. And it was coupled with a down-regulation of MMP-2 protein.

CONCLUSION

S100A7 may play an essential role in the occurrence and development of ESCC and the decreased invasiveness of EC9706 cells mediated by the down-regulated expression of S100A7 may be closely associated with the down-regulation of MMP-2 protein.

The neuroprotective role and mechanisms of TERT in neurons with oxygen-glucose deprivation

Telomerase reverse transcriptase (TERT) is reported to protect neurons from apoptosis induced by various stresses including hypoxia-ischemia (HI). However, the mechanisms by which TERT exerts its anti-apoptotic role in neurons with HI injury remain unclear. In this study, we examined the protective role and explored the possible mechanisms of TERT in neurons with HI injury in vitro. Primary cultured neurons were exposed to oxygen and glucose deprivation (OGD) for 3h followed by reperfusion to mimic HI injury in vivo. Plasmids containing TERT antisense, sense nucleotides, or mock were transduced into neurons at 48h before OGD. Expression and distribution of TERT were measured by immunofluorescence labeling and western blot. The expression of cleaved caspase 3 (CC3), Bcl-2 and Bax were detected by western blot. Neuronal apoptosis was measured with terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL). The mitochondrial reactive oxygen species (ROS) were measured by MitoSOX Red staining. Fluorescent probe JC-1 was used to measure the mitochondrial membrane potential (ΔΨm). We found that TERT expression increased at 8h and peaked at 24h in neurons after OGD. CC3 expression and neuronal apoptosis were induced and peaked at 24h after OGD. TERT inhibition significantly increased CC3 expression and neuronal apoptosis after OGD treatment. Additionally, TERT inhibition decreased the expression ratio of Bcl-2/Bax, and enhanced ROS production and ΔΨm dissipation after OGD. These data suggest that TERT plays a neuroprotective role via anti-apoptosis in neurons after OGD. The underlying mechanisms may be associated with regulating Bcl-2/Bax expression ratio, attenuating ROS generation, and increasing mitochondrial membrane potential.

Multi-therapeutic effects of human adipose-derived mesenchymal stem cells on radiation-induced intestinal injury

Radiation-induced intestinal injuries (RIII) commonly occur in patients who suffer from pelvic or abdominal cancer. However, current management of these injuries is ineffective. Recently, mesenchymal stem cells (MSCs) have been extensively used in regenerative medicine and have achieved a high level of efficacy. In the present study, we hypothesised that human adipose-derived mesenchymal stem cells (hAd-MSCs) could be used as potential tools to heal RIII. We observed that adult Sprague-Dawley rats that received whole-abdominal irradiation benefitted from hAd-MSC injection. hAd-MSCs had RIII-healing effects, including anti-inflammation, neovascularisation and maintenance of epithelium homeostasis, as indicated by elevated serum IL-10, upregulation of vascular endothelial growth factor, basic fibroblast growth factor and epidermal growth factor in irradiated intestine, mobilisation of CD31-positive haematopoietic stem cells or haematopoietic progenitor cells, and the prolonged presence of Bmi1-positive cells within crypts. Consequently, after hAd-MSC treatment, irradiated rats survived longer than non-treated animals. These results suggest that hAd-MSCs have therapeutic potential for RIII management.

Unstable distal radius fractures: restoration of the radial length with use of special palmar fixed-angle plate

PURPOSE

To describe the radiological and clinical outcome of unstable distal radius fractures treated with use of a palmar locking plate designed especially to restore the length of the radius.

PATIENTS AND METHODS

19 patients (6 men and 13 women) with an average age of 55 (23-71) years with an unilateral unstable distal radius fracture were treated with open reduction and internal fixation with use of an special palmar locking plate. In the distal long hole of this plate a longitudinal gear drive mechanism is integrated, in which a digital knob device consisting of a handle with a serrated ring is inserted. By turning the handle the distal fragments which are fixed to the plate by locking screws are pushed distally with respect to the shaft fragment until the correct length of the radius is restored. The patients were followed for 12 months. During last follow-up, standard radiography, functional results and pain scores were assessed.

RESULTS

All fractures united uneventfully with no secondary displacement, and no superficial or deep infection. Ulna variance measured on average - 0.8±1.5 mm. Wrist extension averaged 63°, wrist flexion averaged 59°. Grip strength averaged 82% of the contralateral uninjured side.

CONCLUSION

The used special gear drive plate allows accurate restoration of the length of the radius even in unstable fractures with good clinical results.

A palatal roll envelope technique for peri-implant mucosa reconstruction: a prospective case series study

The aim of this study was to evaluate peri-implant soft tissue changes after performing a palatal roll envelope technique. Twelve patients, presenting a labial flat or concave profile before second-stage surgery, underwent soft tissue augmentation using the palatal roll envelope technique with papilla reservation design. The convex profile on the facial aspect, Jemt papilla index, facial mucosal level, marginal bone level, proximal bone levels of the adjacent teeth, and surgical/prosthetic complications were evaluated before surgery as the baseline, and then reevaluated at 1 week, 3 months, and 6 months after surgery. Data were analyzed using the Friedman test and Wilcoxon signed-rank test. Results indicated that the convex profile and the average papilla index score were improved, while the facial mucosal level was adjusted to a level similar to that of the contralateral tooth at 3 months and then remained stable for the follow-up visit. With the limitations identified in this report, the palatal roll envelope technique can be considered an alternative method to augment the soft tissue during second-stage surgery. This technique obviates the need for another surgical site and papillae area, and also reduces the risks of graft shrinkage and scarring on the labial site.